We spoke with specialists from the Neurology Department at Hisar Hospital Intercontinental about Botox, an important aid in the treatment of chronic migraine, which often troubles patients with attacks especially during seasonal transitions.
What is the role of Botox in the treatment of chronic migraine?
According to the definition of the International Headache Society, you may have chronic migraine if you experience headaches for more than 3 months, 15 days or more per month. Chronic migraine, which is frequently seen in women and between the ages of 20 and 50, greatly affects a person's social life, physical and mental performance. Depression, anxiety disorder and various chronic pain types often accompany these pain periods. Unfortunately, most chronic migraine patients do not receive an accurate diagnosis, their treatments remain inadequate, or due to frequent pain episodes, they resort to insufficient or excessive medication use. Studies have shown that Botox has a reliable safety profile and efficacy as a preventive (prophylactic) treatment in patients with chronic migraine. Botox has been approved by the FDA (U.S. Food and Drug Administration) as a preventive treatment option for chronic migraine. Used for various neurological diseases for 22 years, Botox has been approved in our country by the Ministry of Health since July 2011 for use in the preventive treatment of patients with chronic migraine.
What are the benefits of Botox treatment?
Chronic migraine significantly affects quality of life. Botox application is generally the well-tolerated and only approved preventive treatment method for chronic migraine. Botox has a direct inhibitory effect on pain receptors (nociceptors), preventing the release of pain-causing substances (neuropeptides) and reducing the sensitivity of the pain center to pain. Thus, by blocking pain signals, it indirectly prevents the development of migraine. In patients receiving Botox treatment, a decrease in quality-of-life scores and in the level of disability due to headache, and significant improvements relative to baseline levels, are observed.
How is the procedure performed?
First, we evaluate the patient in detail. We perform the differential diagnosis of the headache and, if necessary, tests, and inform the patient about topics such as the effect of the treatment, side effects and duration of action. We ask the patient to keep a pain diary and monitor the response. Each Botox application takes 15-30 minutes. It is applied to seven separate areas covering the head, neck and shoulders, 31-39 in total, including the pain trigger points, by injecting small amounts with fine needles. Treatment is repeated at the earliest every 12 weeks. The duration of effect of Botox is approximately 3-6 months.
What are the side effects of the procedure and to whom is it not applied?
The side effects, which may rarely occur and are temporary, are pain at the injection site, headache, weakness of facial muscles, itching and skin redness. It is not applied to those who have previously experienced a side effect to Botox, or to pregnant and breastfeeding women.
